The following is an opinion written by Dr. Nick Armstrong, Director of IVMF’s Research and Analytics department.
Last week, the White House unveiled its $1.5 billion Fiscal Year 2022 discretionary budget request. It signals a significant boost (8 percent) in spending on the VA’s budget. The plan increases spending on several necessary priorities, including the pervasive problems of veteran suicide and homelessness. It directs more resources towards future-focused job training for veterans. It increases dollars for new research on evolving veteran needs.
These are the right priorities for the federal government in serving veterans. To be effective, government must put resources to their first best use and prioritize coordination, hopefully leading to cost savings in the future.
Addressing the crises of veterans suicide and homelessness
The discretionary spending request identifies $540 million for suicide prevention programming at the VA. It also provides $2.1 billion to end the systemic issue of veteran homelessness. Our approach to these two complex problems must be connected.
First, the VA must coordinate new efforts to prevent both suicide and homelessness. While the issues are distinct, they are often interconnected and share many of the same precursors. Stressors such as unemployment, housing insecurity, and social isolation are linked to both future homelessness and suicidal ideation. Preventing suicide and homelessness in tandem requires an approach that addresses social drivers and provides clinical interventions for those at risk.
The VA’s Strategy to End Veteran Suicide Objective 8.4 encourages collaboration between mental health providers and organizations impacting social challenges like housing insecurity. New VA programs should move beyond “encouragement” of coordination between health and social services, and towards “requirement” and “incentive.” Integrating health and social services is fundamental to both suicide and homelessness prevention strategies and can lead to cost savings in the future.
Second, any new prevention efforts established under this funding must leverage the power of community-based partners. The VA cannot solve these problems alone. Community-based organizations represent an opportunity to help address the multiple and simultaneous needs that lead veterans to crisis. The VA’s suicide prevention strategy rightfully includes a number of activities aimed at pairing clinical interventions with community prevention approaches.
Programs such as the governors’ and mayors’ challenges to end veteran suicide, VISN Community Prevention Pilots and the Together with Veterans initiative are all programs that build relationships between the VA and communities, integrating health and social care. This is necessary work and deserves more investment. The VA can go further by incentivizing local facilities to work with nonprofit collaboratives in their communities, and by using the new Suicide Prevention Grant Program to support the coordination of services in communities.
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